2019 CMS Program-Specific Measure Needs and Priorities Pre-Rulemaking

1. 2019 CMS Program-Specific Measure Needs and Priorities Pre-Rulemaking Kim Rawlings, CMS CMS Program/Measures Leads April 25, 2019

2. Welcome The meeting is moderated. All lines will be muted during the presentation. The meeting is being recorded and will be uploaded to the CMS website for future viewing. The meeting facilitator will send the link to the recording in a follow-up email.  Questions will be accepted later in the presentation.

3. Agenda • Welcome • Brief Meaningful Measures Initiative Overview • Brief Overview of Pre-rulemaking • Program Needs and Priorities • Segment 1: Chronic and Post-Acute Care Measures • Segment 2: Clinician Measures • Segment 3: Hospital Measures

4. What is Meaningful Measures Initiative? Launched in 2017, the purpose of the Meaningful Measures initiative is to: Improve outcomes for patients Reduce data reporting burden and costs on clinicians and other health care providers Focus CMS’s quality measurement and improvement efforts to better align with what is most meaningful to patients A New Approach to Meaningful Outcomes

5. Meaningful Measures graphic Empower patients and doctors to make decisions about their health care Usher in a new era of state flexibility and local leadership Support innovative approaches to improve quality, accessibility, and affordability Improve the CMS customer experience

6. Meaningful Measures focus everyone’s efforts on the same quality areas and lend specificity, which can help identify measures that: Meaningful Measures Objectives

7. High quality healthcare Meaningful outcomes for patients Meaningful Measure Areas Achieve

8. Meaningful Measures Framework

9. Promote Effective Prevention & Treatment of Chronic Disease 

10. https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/QualityInitiativesGenInfo/CMS-Quality-Strategy.htmlhttps://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/QualityInitiativesGenInfo/CMS-Quality-Strategy.html Meaningful Measures Website

11. Pre-Rulemaking • Statutory Reference • Section 3014 of the Patient Protection and Affordable Care Act • Section 1890 and 1890A of the Social Security Act • Pre-rulemaking Steps • Annually Publish Measures under Consideration (MUC) List by December 1 • Multi-Stakeholder Groups, National Quality Forum’s Measures Application Partnership (MAP) • Annually by February 1 the MAP provides recommendations and feedback to the Secretary

12. Basic Measure Requirements: All Programs Measure reporting is feasible to implement and measures have been fully developed and tested for reliability and validity Sensitive to program goals and statutory requirement Important condition/topic with a performance gap Aligns with CMS programs and across HHS as well as private payer programs Identifies opportunities for improvement No duplicates Feasibility testing for eCQMs Title, numerator, denominator, exclusions, measure steward, link to full specs, established mechanism for data collection

13. Measure Submission • Measures, Change Requests, MUC questions, and Feedback accepted via Jira web-based system • Set up your Jira user account • Email MMSsupport@battelle.org to request access for the current Measures under Consideration project in Jira • Requests are reviewed by respective CMS Program Lead • See User Guide on CMS Pre-Rulemaking web site: https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/QualityMeasures/Pre-Rule-Making.html

14. Center for Clinical Standards and Quality 2019 MUC List: program needs and Priorities

15. Chronic and Post-Acute Care • Inpatient Rehabilitation Facilities Quality Reporting Program • Long-Term Care Hospital Quality Reporting Program • Home Health Quality Reporting Program • Hospice Quality Reporting Program • Skilled Nursing Facility Quality Reporting Program

16. Ask a Question Moderator will provide instruction.

17. Clinician Merit-Based Incentive Payment System (MIPS) Medicare Shared Savings Program

18. Ask a Question Moderator will provide instruction.

19. Hospital • Hospital-Acquired Condition Reduction Program • Hospital Readmissions Reduction Program • Hospital Inpatient Quality Reporting Program and Medicare and Medicaid Promoting Interoperability Program for Eligible Hospitals and Critical Access Hospitals • Prospective Payment System-Exempt Cancer Hospitals Quality Reporting Program

20. Hospital cont. • End-Stage Renal Disease Quality Incentive Program • Hospital Value-Based Purchasing Program • Ambulatory Surgical Center Quality Reporting Program • Hospital Outpatient Quality Reporting Program • Inpatient Psychiatric Facility Quality Reporting Program • Skilled Nursing Facility Value-Based Purchasing Program

21. Ask a Question Moderator will provide instruction.

22. Next Steps • July 2019 TBD: Federal-Only Stakeholder Meeting • Resource for everything MUC • Pre-Rulemaking Web Site

23. Contact for MUC List CMS MUC Coordinators: Helen Dollar-Maples — Helen.Dollar-Maples@cms.hhs.gov Kimberly Rawlings — Kimberly.Rawlings@cms.hhs.gov Measures Manager— Pre-Rulemaking: Vince Brown — brownv@battelle.org 614.424.5928